Section 400-B:4 Policy Record File.
I. A policy record file shall be maintained for each policy issued, and shall be maintained for the duration of the current policy term plus 5 years, or for life insurance policies and annuity contracts, for the time the policy or contract is in force and 5 years thereafter. Policy records shall be maintained to show clearly the policy period, basis for rating, and any imposition of additional exclusions from or exceptions to coverage. If a policy is terminated, either by the insurer or the policyholder, documentation supporting the termination and account records indicating a return of premiums, if any, shall also be maintained. Policy records need not be segregated from the policy records of other states if the records are readily available to market conduct examiners as required under this chapter.
II. Policy records shall include the following:
(a) Any application and accompanying records for each contract. The application shall bear a clearly legible means by which an examiner can identify a producer involved in the transaction. The examiners shall be provided with information clearly identifying the producer involved in the transaction;
(b) Any declaration pages (the initial page and any subsequent pages), the insurance contract, any certificates evidencing coverage under a group contract, any endorsements or riders associated with a policy, any termination notices, and any written or electronic correspondence to or from the insured pertaining to the coverage. If any of these records has already been filed with the commissioner, a separate copy of the record need not be maintained in the individual policy files to which the record pertains; provided, that it is clear from the insurer's other records or systems that the record applies to a particular policy and that any data contained in the record relating to the policy, as well as the actual policy issued to the insured, can be retrieved or recreated;
(c) Any binder; and
(d) Any guidelines, manuals, or other information necessary for the reconstruction of the rating, underwriting, policy owner service, and claims handling of the policy. The maintenance at the site of a market conduct examination of a single copy of each of the above shall satisfy this requirement. These types of records include, but are not limited to, the application, the policy form including any amendments or endorsements, rating manuals, underwriting rules, credit reports or scores, claims history reports, previous insurance coverage reports (e.g., MIB), questionnaires, internal reports, and underwriting and rating notes.
III. A declined underwriting file shall be maintained and shall include an application, any documentation substantiating the decision to decline an issuance of a policy, any binder issued without the insurer issuing a policy, any documentation substantiating the decision not to add additional coverage when requested and, if required by law, any declination notification. Notes regarding requests for quotations that do not result in a completed application for coverage need not be maintained for purposes of this chapter. The insurer shall retain declined underwriting files for the current year plus 5 years.
Source. 2005, 221:1, eff. Sept. 3, 2005.